Poster Presentation

Category: Treatment & Health

Presentation Date & Time: 03/24/98 12:00:00

Great strides have been made in the battle against HIV. This was shown in the findings of AIDS Clinical Trial Group (ACTG) 076. Perinatal transmission sharply decreases with the use of zidovudine (ZDV) during pregnancy, delivery, and for newborn administration. The Helena Hatch Special Care Center (HHSCC) at Washington University School of Medicine is funded by a Special Projects of National Significance award. Using a one-stop-shop multidisciplinary team approach, HHSCC provides comprehensive medical and psychosocial care to 85% of all known women with HIV in the St. Louis metropolitan area. Ninety percent of these women represent the changing face of HIV today: single-head of household, economically disadvantaged, women of color. HHSCC has constructed guidelines and measures to ensure that the ACTG 076 protocol is implemented in communities where lack of resources and general distrust of medical institutions are major barriers to receiving the most basic health care. The guidelines focus on: 1) increased coordination between Pediatric and Adult Infectious Disease specialties through joint case conferencing, 2) Pregnancy Process checklists, 3) peer support and 4) close patient/provider contact in the home, hospital and outpatient clinic. The rate of vertical transmission for women of HHSCC before implementation of ACTG 076 and the HHSCC guidelines in 1994 was 44.4%. With the use of the ACTG 076 protocol and the HHSCC guidelines, the vertical transmission rate dropped to 9% in 1995 and 0% in 1996. We recommend replication of HHSCC guidelines in other programs for use in implementing ACTG 076 in multidisciplinary health care sites that serve women with HIV. The guidelines can also be used in broadening reproductive health counseling.